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GI II Exam 1 > Pancreas Path I > Flashcards

Pancreas Path I Flashcards

1
Q

pancreas

A

has head, body, tail

gland acini

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2
Q

tumors of pancreas

A

most arise from epithelium of large ducts

adenocarcinomas

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3
Q

pancreas divisum

A

improper fusion of duct

duct of santorini does not obliterate becomes main drain - to minor papilla to small bowel

and duct of wirsung becomes insignificant - may drain lower pancreas

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4
Q

embryo of pancreas

A

rotation of ventral anlagen
-rotates toward dorsal and fusion takes place

normally - has duct obliteration and wirsung duct left behind

duct of santorini obliterates and minor papilla nonfunctional

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5
Q

ERCP

A

can be used to see pancreas divisum

dye to ampulla of vater - no dye to pancreas

in minor sphincter - do see dye in pancreas

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6
Q

predisposition to chronic pancreatitis

A

pancreas divisum

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7
Q

annular pancreas

A

double bubble sign

part of pancreas drags behind and wraps duodenum

usually below sphincter of oddi

see green-tinged vomit**

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8
Q

double bubble

A

annular pancreas

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9
Q

bile tinged vomit

A

annular pancreas

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10
Q

acute pancreatitis

A

acinar cell injury or obstruction of ducts of pancreas

trypsin from acini - to small bowel - activated there so doesn’t destroy pancreas

enzymes digest pancreas in pancreatitis

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11
Q

mild acute pancreatitis

A

inflammation, edema, reversible

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12
Q

severe acute pancreatitis

A

life-threatening

-ARDS, shock, DIC

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13
Q

chronic pancreatitis

A

repeated bouts

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14
Q

causes of acute pancreatitis

A

alcohol
gallstones

also mutations in trypsin protein - shock - trauma - vasculitis - mumps

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15
Q

alcohol acute pancreatitis

A

better prognosis - but still bad

40yo male

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16
Q

biliary stones in acute pancreatitis

A

brown stones
female age 70yo
worse prognosis

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17
Q

pancreatitis path

A

autodigestion

saponification of parenchyma and adipose

injury can be to duct or to acini or both

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18
Q

duct obstruction in pancreatitis

A

initially edema

  • secondary impaired blood flow
  • ischemia

cells of duct begin to malfunction

spill enzymes to tissue - autodigests

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19
Q

PRSS1, SPINK1, CFRT

A

mutations in trypsin
acute pancreatitis

high risk of pancreatic cancer as well

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20
Q

diagnosis of acute pancreatitis

A

epigastric pain to back
fever, N/V

elevated serum amylase and lipase

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21
Q

acute pancreatitis early

A

enlarged with edema and red

some early white saponification

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22
Q

chronic pancreatitis

A

multiple bouts of acute

most common cause - alcohol abuse

also autoimmune - IgG4, and genetic mutations in trypsin

23
Q

repeated bouts of epigastric pain to back followed by malabsorption

A

chronic pancreatitis

24
Q

early chronic pancreatitis

A

days to weeks

25
Q

intermediate chronic pancreatitis

A

months to years

26
Q

late chronic pancreatitis

A

years to decades

hard - sclerotic tissue - calcifications

27
Q

chronic pancreatitis

A

lots of pancreas is fibrotic

get calcifications that you can see on CT/Xray

28
Q

chronic pancreatitis complications

A

calcification can cause severe pain - perineural fibrosis

stones

diabetes

ascites - constant destruction of peritoneal surfaces

pseudocysts

pleural effusions - ascites can traverse diaphragm

fat malabsorption**

29
Q

true cyst

A

epthelial lining

  • usually neoplasm - b9 or mal
  • will continue to grow
  • inside - depends on epithelium
30
Q

pseudocyst

A

have no epithelium

  • usually filled with something
  • fluid not made by what is lining wall
  • usually lined with granulation and chronic inflammaion
  • usually do not grow in size
31
Q

abscess

A

get walled off - creates area of fibrosis

  • walls off acute inflammation
  • pain and systemic infection

if remains in place - what is left is pseudocyst
-lining of cyst - no epithelium

32
Q

pseudocysts in pancreas

A

inflammatory response to digestive enzymes in pancreas

pseudocyst forms

lined with inflammatory wall** - no epithelium

33
Q

serous cystadenoma

A

elderly 60yo

make serous yellow fluid

makes cysts

benign

34
Q

mucinous cystic neoplasm

A

mucin producing

create cysts

benign, borderline, malignant all common

35
Q

pancreatic serous cystadenoma

A

smooth border - tumor full of lots of cyst

-yellow straw colored fluid - serous fluid

benign

36
Q

slow growing painless mass in adult women in pancreas

A

mucinous cyst neoplasm

need to look at biopsy

37
Q

pancreatic mucinous cystadenoma

A

smooth borders
-likely benign

mostly tall of pancreas

lining - epithelium making mucin - fills cyst

38
Q

intraductal papillary mucinous neoplasm

A

duct epithilium produces neoplasms growing to obstruct lumen
-continue to grow and expand

mostly male - mostly benign - mostly head of pancreas

39
Q

carcinoma of pancreas

A

4th leading cause of death in US

risk fx - old age, smokers, diet, hereditary

when discovered - widely metastatic

painless jaundice with pruritits

40
Q

epigastric pai to back, jaundice, pruritis

A

possible pancreatic cancer

41
Q

migratory thrombophlebitis

A

troussea sign

with pancreatic cancer

42
Q

courvoisiers

A

palpable gallblader with pancreatic cancer

43
Q

virchows node

A

left supraclavicular

with pancreatic cancer

44
Q

sister mary joseph

A

umbilical skin mass

with pancreatic cancer

45
Q

blumers shelf

A

rectal pouch mass
-drop mets - to this location

with pancreatic cancer

46
Q

smoking risk fx for cancer in

A 
pancreas
lung
HNSCC
bladder
esophagus
47
Q

diagnosis of pancreatic cancer

A

CT scan common
endoscopic ultrasound

fine needle aspiration or needle core bx

48
Q

Ca 19-9

A

elevated in pancreatic cancer

marker to follow treatment

not for diagnosis

49
Q

aspiration

A

cell sucked out of tissue with negative pressure

50
Q

exfoliative

A

scraped off surface

51
Q

adenocarcinoma of pancreas

A

really hard - with irregular borders

52
Q

KRAS

A

12p chromosome

altered in invasive pancreatic adenocarcinoma

53
Q

desmoplasia

A

connective tissue deposition - makes tumors hard

GI II Exam 1 (29 decks)

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